Computer tool tracks, improves seniors care
March 23, 2011
RAI ‘report card’ helped Jerry regain strength, mobility
Story and photos by Gregory Kennedy
EDMONTON — “Now I’ve started to live my life. It’s changed. I could hardly lift my hands before — and now I can be more independent,” says Jerry Onyschuk, 60, who has MS and uses a wheelchair.
When he moved into CapitalCare Dickinsfield in northeast Edmonton in June 2009, he would wake up each day to severe pain; in fact, his muscle and joint spasms ranked at the top of the scale used to measure such pain.
Today, he’s pain-free, thanks to an improved care plan put in place over the past year in response to data, gathered in quarterly assessments, which create a kind of snapshot, or ongoing ‘report card’, about his overall well-being.
“I’m now able to exercise on the pedal bike with my arms. It’s such a great feeling. The last time I could do that was probably about 10 to 12 years ago,” he says.
Quality of care for Onyschuk and the 14,600 Albertans living in long-term care centres across the province is greatly improved thanks in part to the growing success of a computerized assessment tool that helps caregivers create care plans that adapt to the changing needs of residents.
The Resident Assessment Instrument (RAI) 2.0 is a comprehensive physical, mental, and social assessment given every three months to every long-term care resident. It is widely used in over 30 countries around the world, including Canada and the US, and was endorsed by Alberta in 2007.
Using RAI data, Onyschuk’s care team was able to determine that his pain was caused by spasms. Jerry was referred to the spasticity clinic at the Glenrose Rehabilitation Hospital. Injections to his joints and muscles eased spasms, while medication changes and physio also helped him to regain his strength and mobility.
CapitalCare, the country’s largest public continuing care provider and a wholly-owned subsidiary of Alberta Health Services, was an early adopter of the system that is now used provincewide.
“The most important treatment we can give a person living in our care is to improve their quality of life,” says Francine Drisner, an administrator and RAI lead for CapitalCare. “In Jerry’s case, RAI data quite literally enabled us to take away his pain, giving him his life back. Now he can look forward to each new day, rather than dreading it.”
RAI generates data on 24 quality indicators including quality of life; potential or history of falls; medication use; nutrition status; monitoring of urinary tract infections, wounds; and physical functioning.
Since the implementation of RAI, resident care plans have become more current, patient-focused and comprehensive. The system allows nursing staff to monitor residents more closely and provides a more active role for all members of the care team. Families have noticed that care centres have a more consistent level of care.
Since all long-term care operators across the province are using the system, comparisons can be made and information can be shared across organizations, thus creating a more consistent approach to long-term care in Alberta and across the country.
The system was created by interRAI, a collaborative network of researchers in over 30 countries committed to improving health care for persons who are elderly, frail, or disabled. Its use is growing. One of the world’s largest economies, the State of New York, in the United States, is now proceeding to adopt the RAI tools to improve its long-term care.
RAI is also used in North America (Canada and U.S.), Europe (Belgium, England, Finland, France, Germany, Iceland, Italy, Netherlands, Norway, Spain, Sweden, Switzerland), Asia (Hong Kong, Korea, and Japan), and Pacific Rim (Australia, New Zealand).
“I love living here. It’s been a real home,” says Onyschuk, a bird fancier who buys feeders and seed to the delight of his fellow Dickinsfield residents. “This summer I’ll get a birdbath for our garden. I love watching the birds.”
